Dear preceptor

[Ivanna_Nurse]

Dear preceptor.. I came to you smiling, full of energy and ready to tackle the last leg of my orientation journey, with your guidance of course. I haven't really gotten any inclination on where that guidance is at. You tell me what patients to take, and I take them. Then when I am at the bedside, communicating with the family (you know that rapport thing?), you decide that it is a great time to tell me *not to touch the patient*, or the machines for that matter unless you are there. What? I did not fall off of the nursing school wagon yesterday. I am new to your facility, but not a new grad. I did get a smug sense of satisfaction when the family told you it was fine and I was handling things.

I see that you do not have any intention of assessing my skill level or evaluating areas in which I need assistance. In your eyes, I have no skill level or even brain stem function because every action on my part is met by you with some sort of resistance or interrogation. You cant wait for me to come out of the bathroom before you call the doc... making me look like some sort of fool that cant call the doctor. Lo and behold the toilet flushes and I am greeted with 75 orders, all of which you *write* but make me *do*. Although I am a critical care nurse, and am comfortable with bedside procedures, it is *imperative * on your part to ensure that I am educated on sterile fields and how to open packages. That makes me feel so great, especially with the doc at the bedside.

Precepting with you has given me a great opportunity to practice dealing with "the cold shoulder, being aloof and unapproachable." I *know* that you aren't any of those things, just preparing me for when I run into someone who is. Thanks! I am now well versed in forced conversation, fake enthusiasm, and being lonely but not alone.

I have been practicing my mental, telepathic and psychic abilities... seeing as how there isn't any verbal interaction between us, its time to take it up a notch. *places fingertips to temples* Can you hear me now?

Here is an interesting thought. You breeze in, tell me how the lights have to be like this, and these lines need to be like this and so on. I am respectful of those requests. I like things a certain way too.. try to be mindful of that. The road goes both ways here. The same goes for documentation. Maybe you could ask me why I wrote a certain thing before you scratch it out and write error... although all the extra embellishments make my flow sheet look freakin fantastic, right?

When I ask you about something, especially when its a policy and the rationale for not following it... I just love when you get mean and flash those *knowing* looks to all your friends at the desk.

Precepting with you has been quite the experience, and as life goes, all things must come to an end. Now that our journey is finished, know that I will *never* forget you.

Love, your preceptee

[tinybbynurse]

I have been lucky enough to have amazing preceptors for my hospital jobs and overall avoid all the horror stories of a bad orientation...I'm very grateful for that. I've had several preceptors between day and night shift. That being said, ive had great preceptors until now, I've recently encountered a preceptor during the end of my orientation to NICU who isn't my favorite....when giving feedback to the educator who I met with recently since she likes to touch base through out orientation, they seem to think I'm not ready to be on my own, and the things that they thought I could work on...well...they never even told me, they passed it on to the educator to tell me...how can I get better if I didn't know you felt that way? How can you go 3-4 shifts and never tell me and expect me to improve when I would if you actually told me? The other person I'm precepting with now (there's a couple) tells the educator she thinks I'm where I need to be to be ok on my own soon. Two totally different opinions.

guess what? Lo and behold my educator wasn't surprised at all to find out which preceptors have worked better for me and which haven't...other orientees have had the same experience with that one preceptor. I feel good about where I'm at and I told my educator that. She does not see the need to extend my orientation and feels that my areas that need improving are typical and expectant of someone new to NICU rather than reasons worthy of extending my orientation. I'm old enough now and though early in my career, far along enough that I know not to let one person's opinion make me feel like I'm not ready when I feel I am, and others do too. It's definitely important to maintain ties with your educator because after they hear all sides of things, from you and ALL of your preceptors, it's easier for them to paint the picture of whether you're doing okay, need more time which is reasonable and totally okay, or if a single preceptor just has a totally different perspective about your performance that really isn't overall reflective of your performance as a whole.

I think we've all been there before, in nursing school with an instructor, in a job with a preceptor, or even with a parent....where someone didn't believe in us and if we let our minds take shape of the way one silly person thought of us, we'd never be where we are doing just fine after all! Sometimes the problem lies in your mentor/preceptor/instructor etc, and not you. That being said, it's okay to learn from them and respect their knowledge, but you don't have to let all of their opinions mold you. You're in control of how you feel about you. They aren't.

so, I just want to say a couple things. Preceptors, specifically NICU, respect your orientee who has previous nursing experience, just not in this speciality. This is all new and there's a lot to it...don't expect me to have everything down to a t. I am old enough to be completely okay with the fact that I am learning and that this is not easy stuff and While my standards are high for myself, I'm not going to beat myself up too much. When I was younger, I'd feel like maybe I'm not up to par, but now I know that hey, nursing isn't easy! I did just fine at my last job and I'm doing well here, too considering all the new things I'm learning! Also, preceptors, not everyone learns the way you do. And COMMUNICATE. If your orientee can improve on something, tell them!! They may not realize they needed to or would be happy to oblige if they know what's expected of them. Don't hand off things to the educator after 3 or 4 shifts during which we could have improved in the areas you wanted us to, had we actually known.

And lastly, to those orienting, new grads, few years experience, a lot .... if you feel good about where you're at, then don't let one person's opinion throw you off. I would have when I was a few years younger or even newer of a nurse, and I'm a fairly new nurse though not new grad. They don't define you. If you feel you need more time, there's nothing wrong with that either. Accept constructive criticism and take everything with a grain of salt. If you feel you're doing okay say so when you speak to educator etc. see if they agree. In my case, my overall performance is good, and my educator was happy to talk to me to find out that this particular preceptor just expects too much of all of her orientees, and she actually is the one who needs to lower her expectations. I think some people have gotten really good at their jobs and forgotten what it's like for it to be new to them.

Most people are really nice on my unit. You will always have your outliers.

Preceptors, don't be demeaning, give healthy feedback, and don't get all high and mighty on people! Orientees, believe in yourself, try your best, continually improve, and be comfortable with respecting the fact that you are learning and it's an ongoing process. If you don't have a healthy respect for the reality that you are learning and that you're not born knowing how to do this skill and that, then you will always feel inferior and beat yourself up. Don't! You'll burn out too fast! Being a nurse isn't easy and if this were all a breeze you'd be off orientation in a week or else you're just already very familiar with your specialty. Even experienced nurses usually spend longer than that just learning the ways of that particular unit.

ive only got a couple shifts left with one preceptor, and a couple with another. I imagine I'll probably have a better experience with one of them over the other, but even with the less than fortunate one, I plan on making the best of it and being glad I have limited time left with them. Haha.

[tinybbynurse]

Also, I've seen experienced nurses throw new nurses under the bus for mistakes I've witnessed them do themselves...turning their back to a baby in an open bed, not charting something, etc. point is, everyone makes mistakes. They aren't specific to being new, though they may lessen with experience they do still happen. Some nurses will try to make you feel bad for that. Don't linger. Learn and move on. Guarantee you at some point you'll witness them make a mistake, even a little one, in your presence. Did this or forgot to chart that...etc etc. no one is immune to them so just know that.

[3rdGenRN]

I had the same experience as a new grad. Yes a new grad needs more hand holding than an experienced nurse, but these attitudes and nitpicking are totally inappropriate and don't create an atmosphere of learning or trust. I had 3 preceptors, this one almost ran me out, and that takes a LOT from me. The first just wasn't a great preceptor for training a new nurse, the 3rd was amazing and in 3 weeks turned me from someone whose job was on the line because of #2s poor reports that by the end were a result of my complete inability to overcome the anxiety from her insanity to a functioning, independent nurse who was getting great reviews from my whole team.

Funny, we have 2 experienced nurses and 3 new grads on the unit now and she hasn't been given a preceptee. In fact, not one preceptee, experienced or new grad, since me.

She now refuses to take report when she's my relief. And I've found her digging through my charts on my patients that aren't hers, she doesn't do that with other charts.

[Reyn04, MSN, RN]

My first preceptor as a new grad was my worst. I came into a Critical Care position that afforded me 5 months of orientation but at 6 weeks in, when my fellow new grad (with different preceptor) was moving from managing 1 patient to 2 (it was a 3 pt assignment in that department), I was still only being given task oriented assignments (as in: give NGTube meds here, now go watch peritoneal dialysis there, watch this chest tube canister change on that one, watch this wound vac dressing change over there...) not growing my full-on big picture skills. In spite of 20 years experience, my preceptor was seemingly disorganized & would stay late (by 1-2 HOURS) to complete her charting and that was without taking a lunch break every 12 h shift! Even her shift report was so interspersed with personal stories & "I forgots" that nights was often delayed in starting while she took 45+mins to report on 3 patients.

Thankfully I was in new grad orientation where we were had regular meetings with staff-ed & the other new grads to talk about our experiences. I sat down with staff ed & told them I was not getting what I needed from my preceptor. By the next morning a plan was in place to move me to nights to work with a different preceptor (it was a day/night rotation position I was going to train on nights anyway but they moved it up a month). It felt like a punishment - the way it was dropped on me, but it was a blessing.

My new preceptor was excellent & I learned a LOT about organizing my shift, charting (paper flow sheets) in a timely manner, and time management. I learned to use the tools at my disposal to see the BIG picture in patients & how small changes could make a huge difference in patient condition.

I dont mean this as a slight to younger nurses but I am glad I became a nurse at a middle age, MY earlier self may have been to meek to speak up about the poor training. As for the preceptor... we were co-workers for less than a year when she moved on but later, she went into teaching (at the school I'd attended). I hope she does a better job with them.

[3rdGenRN]

Oh I know this preceptor. She's a critical care nurse too. It was miserable. She almost cost me my job.